Cervical cancer screening has dramatically decreased cervical cancer mortality in the US, yet there is a strong need for optimization of cervical cancer screening due to many factors, including the availability of multiple screening tests; the availability of HPV immunization; the need to balance benefits and harms through selection of appropriate screening ages, intervals, and screening tests; the need to identify critical points of failure in the screening processes; and the massive economic costs of cervical cancer screening in the US. The existing Vermont PROSPR Research Center at the University of Vermont is a statewide registry of breast cancer screening with 20 years of experience in collecting integrated screening process data. In this revision application, the Vermont PROSPR Research Center (VPRC) proposes: (1) To collect high-quality, multilevel cervical cancer screening process data among women in the state of Vermont; and (2) To lead and participate in collaborative multicenter research projects within the PROSPR consortium. We will create a statewide registry of cervical cancer screening exams and biopsy results, which will include Pap smear, HPV tests, and cervical biopsies interpreted by 7 hospital laboratory facilities in the stat as well as such tests interpreted out of state for Vermont women attending the eleven Planned Parenthood clinics. The second tier of our approach will consist of more detailed screening process data ascertainment from the electronic health record systems of Fletcher Allen Health Care (affiliated with the University of Vermont), the Community Health Centers of Burlington, and Planned Parenthood of Northern New England. Together, this data will provide a rich source of high-quality cervical cancer screening data for a sizable and diverse population-based cohort that includes a wide range of the spectrum of health care settings experienced in the United States. We have assembled a multidisciplinary research team with extensive collaborative experience and expertise across the cervical cancer screening spectrum, including primary care, cervical pathology and HPV testing, diagnostic work-up and treatment, and comparative effectiveness research. We are well poised to rapidly contribute both important cervical cancer screening data to the PROSPR central data repository and valuable expertise towards the evaluation of the cervical cancer screening processes in collaborative projects.